Since the start of the Wolf administration, we have made it a priority to improve the quality of care provided by the owners and operators of Pennsylvania’s skilled nursing facilities. Many of these facilities already provide excellent care to their residents, and we are continuously working to ensure the safety of every resident in their care through regular updates to guidance and regular inspections, including investigating every complaint.
Almost immediately after its identification, covid-19 became known for disproportionately affecting older adults. Like other illnesses, it also posed a particular threat to long-term care facilities due to the nature of congregate care. To help prevent the spread of covid-19 among this vulnerable population, we instituted guidance from the Centers for Disease Control and Prevention (CDC), including limiting outside people from entering long-term care facilities.
Despite these efforts, staff members who have dedicated their lives to caring for these vulnerable Pennsylvanians unknowingly contracted covid-19 in their communities and carried it into these facilities.
In accordance with guidance from the CDC and the Center for Medicare and Medicaid Services (CMS), residents who contracted covid-19 were isolated from the general population. Some of these residents became ill enough to require more advanced medical care and were taken to hospitals. When these residents recovered, they returned to the facilities they called home.
This was best for these patients as studies show people get better when they are at home.
These residents did not introduce covid-19 when they returned home to these facilities because it was there that they first came into contact with the virus. And, again, these residents were separated from others who were believed to not have covid-19, just as they had been before they required hospital-level care.
Many facilities in Pennsylvania succeeded at containing covid-19 by following these protocols. Unfortunately, in some facilities, covid-19 spread more widely.
Whenever a long-term care facility reports even a single case of covid-19, the Department of Health considers it an outbreak, conducts an assessment of the situation, and offers up a variety of resources. These resources include having the facility work with Department of Health staff to identify measures to slow and stop the spread, utilize the services of ECRI, our infection control consultant; or deploying the Pennsylvania National Guard to assist with staffing.
The Department of Health cannot force facilities to accept these services, even in circumstances when we feel they may be beneficial. Some facilities may refuse the assistance out of fear that they will be cited for failing to follow procedures. This is not the Department of Health’s intention — our top priority is halting covid-19, not issuing citations.
In fact, we’ve supported long-term care facilities throughout the pandemic with more than 2,200 shipments of personal protective equipment, including more than 2 million N-95 masks. We have continued to conduct virtual inspections, as well as on-site sections when circumstances warrant them.
And we are supporting the identification and isolation of covid-19 cases through a universal testing order requiring all nursing homes to complete initial baseline testing no later than July 24. We had recommended universal testing on May 12, believing nursing homes would be eager to take this common-sense approach to identifying the virus. A recent survey showed 40% of facilities are testing, but the department feels strongly that we need 100% of the facilities to complete this testing. The department has issued this order to spur the remaining facilities to do universal testing and took the time to organize operational capabilities to support them.
We are already seeing a significant decline in new cases in staff and residents, as well as a decline in deaths, and we will continue to provide support to long-term care facilities as they identify, isolate and rehabilitate cases of covid-19. And we will continue to pursue additional tactics that will allow us to protect and improve the quality of life for Pennsylvanians in long-term care facilities — during this pandemic and beyond.
Dr. Rachel Levine is Pennsylvania’s Secretary of Health
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